Revealed: The inside story of Mayo University Hospital's ongoing crisis

Consultant condemns Health Minister's attack on facility and its staff

by Dr. Lisa Cunningham

When the Minister for Health, Jennifer Carroll MacNeill, was asked on the Anton Savage show on Newstalk on October 18 last about popping up in emergency departments unannounced, she stated: “That’s the way I’m doing it, if they don’t like it, they can leave.”

The throw-away comment is not an encouraging one for the current healthcare staff, nor is it inviting to healthcare staff coming into the Irish healthcare system.

It is a derogatory, flippant comment that displays her view of leadership.

The PR spin about our Mayo University Hospital is belittling and degrading of the everyday work that is done in our hospital.

It depreciates every one of our staff who work tirelessly every day to look after our sick and ailing.

Our staff and patients are not to be used as political pawns.

I penned this article to reassure our Mayo public that Mayo University Hospital (MUH) staff is taking the minister’s recent comments and attacks on our hospital very seriously.

Indeed many of your readers actually work in the hospital, have family members who work in our hospital or have used our hospital services.

They have vocalised to us healthcare staff their anger and confusion at her outburst in Dáil Éireann.

Our local representatives, of many parties, are very aware of the true statistics from our hospital.

They have been regularly engaged and supportive with many of the healthcare staff over the past few years.

It has been a key election topic about improving our services in our local hospital. However, their silence now speaks volumes to us.

Many of you, the public, have reiterated this to the staff of Mayo University Hospital over the past few weeks.

Many of you feel let down by the lack of support of the hospital by certain local politicians.

Political goals are not conducive to true patient advocacy.

EMERGENCY DEPARTMENT PROBLEMS

Another Minister for Health and another apportion of blame, of a failing health system, to the ED department.

It's tiring listening to consecutive ministers blaming one department alone and its staff (or lack of).

It shows an absolute lack of understanding of the bigger picture.

Patients in Mayo, for the majority, have no other option but to attend the ED as the services are not available for their health concern elsewhere.

There are no minor injuries clinics, no rapid access clinics, no pathfinder with the national ambulance service and a reduction in GP accessibility for patients.

I could go on.

However, the Mayo public and patients are very aware of these.

So too are the local representatives, yet they have remained so quiet lately, despite knowing and advocating for the local public who have contacted them consistently about these over the years.

The ED presentations are averaging 120 per day with one of our higher days (Monday and Tuesday) seeing regularly 150-160 per day.

Recently we hit the highest ED presentations of 170.

This is a significant rise over the past few years and brings us very close to other EDs in our HSE West/North West group.

Allow me to thank the public so much in your very vocal support to our ED and MUH staff over the past few weeks.

You see through our eyes how hard our MUH staff work and under the conditions that we have been reduced to by our government.

STAFFING ISSUES

The rhetoric that “Mayo University Hospital is well staffed” is one that is the biggest source of disappointment for the healthcare staff.

This was stated by our Minister for Health in the Dáil during her exchange with Paul Lawless TD (September 19, 2025).

It was also stated in her letter to the public representatives on October 17, 2025.

In her letter she compares the staffing of Mayo University Hospital to all the other Model 3 hospitals (of which there are 17).

She compares our hospital with, for example, Naas General Hospital.

This is not, in any way, a fair comparison in terms of activities within the hospitial, bed capacity, rurality, patient population, etcetera.

It’s a blanket superficial to paint all Model 3 hospitals with the same brush but does not take into account the intricacies of each of the hospitals.

In her letter she also acknowledges that Mayo University Hospital was not in receipt of the nursing safer staffing level minimum requirements.

This is an essential government policy that has been committed to and funded for, as she states herself in the letter.

She is aware that there were “difficulties in its implementation”.

This has led to Mayo University Hospital not achieving the safer staffing level which is outlined by her own government policy.

She also acknowledges that we have 18.5 nurses short in our emergency department alone (based on 2021 figures so these are not current figures).

Mayo University Hospital has now been suddenly allocated the funding for recruitment of these 18.5 nurses in the past four weeks.

So although she states we are not understaffed in Mayo University Hospital, she states we do not have the actual safer staffing level as is essential by her own government policy.

This is conflicting.

THE 'DISCHARGES' ISSUE

The Minister’s sole blinkered view into weekend discharges is a disguise to paint the picture of consultants not being present at the weekends for senior decision making.

It is also a back hand slap to the consultants who have not signed up to the public-only consultant contracts.

She has been very vocal about this since the start of her term.

Anyone who has been in our hospital at the weekends are very aware that there are consultants on site.

For example, radiology services are occurring on weekends. Our radiology department, in particular, were very vocal, in our local staff meeting, about her false statement in the Dáil regarding virtually no diagnostics occurring.

It is certainly not reflective in their statistics in comparison to our other hospitals in our group or other hospitals outside the group.

Mayo University Hospital is actually one of the top hospitals for acute hospital discharges, well above Sligo and Letterkenny. (National Acute Medicine Programme 2024)

Weekend discharges are a small piece of a jigsaw that the minister feels is one of the key pieces.

The public only consultant contract and weekend working by the consultants is one of the biggest annoyance of the Minister for Health.

It is constantly being discussed by the Irish Medical Organisation and Irish Hospital Consultants Association (neither of which she has engaged with at their national meetings).

This is a whole other area that needs another extensive article.

BED CAPACITY ISSUES

It would be remiss of me not to mention bed capacity when talking about the ‘emergency department problem’.

As a consultant colleague once tried to explain in a senior meeting, if a hotel has a defined amount of rooms, it cannot book in extra customers and make them wait in the hotel lobby.

It predicts the demand and caters for it.

We have multiple methods of prediction of acute hospital bed capacity in Ireland.

The ESRI has predicted how many acute beds based on evidence from our population trends and aging population.

The 2023 ESRI ‘Inpatient bed capacity requirements in Ireland in 2023: Evidence on the public acute hospital system’ report stated: “This bed capacity deficit is likely a key contributor to recent overcrowding issues experienced in public acute hospitals.”

With this in mind, multiple successive governments try to address bed capacity but it is a catch up game.

The government’s ‘Acute hospitals bed capacity extension planv2024-2031’ outlines what hospitals are to get extra beds in this timeframe. (appendix 1 at the very bottom- HSE West and North West https://assets.gov.ie/static/documents/acute-hospital-inpatient-bed-capacity-expansion-plan.pdf)

Mayo University Hospital has had 10 new beds delivered in 2021-2024 and is in line for 96 new acute beds from 2029-2031, according to the government’s plan.

If we do not have the beds for patients to physically be admitted to, they have no option but to wait on trolleys until other patients are discharged from the wards.

Hence, labelling another health system deficit is a problem of one department: The Emergency Department.

THE FUNDING QUESTION

Finally, in the minister’s letter dated October 17 last, she references that the HSE region of West/North West is not “disadvantaged in any major way from policy or resources.”

There are multiple obvious points to display that the region is obviously deficient in policy.

She gives the example in her letter of the essential government policy of safer staffing having not been implemented.

However in the past month the funding has been allocated and secured for the 18.5 deficit ED nurses that are needed. This is only pertaining to the ED. This does not include the other areas of the hospital, which are deficient also.

I would like to share the funding break down of our West/North West hospital that was a parliamentary question so our Mayo public can make their own impression in relation to funding:

Just to give a further example of the lack of funding for Mayo University Hospital- I show the pharmacists allocations across our hospitals.

Mayo University hospital is different to Letterkenny and Galway University hospital as the MUH pharmacists are also responsible for medicines off site to inpatient services, for example Sacred Heart Hospital, An Coilín, etc.

This would equate to approximately 600 acute patients, including these off sites.

Galway University Hospital (including Merlin Park Hospital beds) is approximately 713 beds.

Yet Mayo University Hospital has only 27 whole time equivalent pharmacists in comparison to 67 in Galway University Hospital.

We have the lowest allocation of pharmacists in the West/North West region despite having one of the highest patient cohort of the model 3 hospitals.

This has been raised several times by our pharmacy department.

I hope this goes some way to explaining the staff’s perspective to our patients and our public.

We, healthcare staff, are used to ministers coming and going.

However such a unwarranted attack on us the staff is not something we are prepared to stand for.

We are in healthcare to work for our patients and advocate for them. That is our job.

It is well documented that healthcare staff are doing the best they can with the resources they have.

Let’s hope that the healthcare staff don’t take up the minister’s offer in her comment of: “If they don’t like it, they can leave”.

Instead it would be better to listen to the boots on the ground and question how staff and public could have such a different perspective that is not reflective of her statistics in front of her.